Insured rate dips again, to 9.4% in 2018

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Dive Brief:

More than 1.1 million Americans lost health coverage in 2018, according to Centers for Disease Control's National Health Interview Survey. The total number of uninsured Americans increased to 30.4 million, up from 29.3 million in 2017.

Among surveyed adults aged 18-64, CDC found 13.3% were uninsured, 19.4% had public coverage and 68.9% had private health coverage.

Altogether, CDC estimates 9.4% of Americans were uninsured as of 2018. The agency notes that the rate is "not significantly different" than 2017, although it represents a drop in uninsured of 18.2 million people compared to 2010.

Dive Insight:

The Trump administration has been whittling away at the Affordable Care Act for two years. Stripping the law of several insurer-stabilization mechanisms and pushing bare-bones, non-compliant health plans has led to a rise in premiums and in the rate of uninsured.

Meanwhile, the U.S. Department of Justice is working to kill the law completely. In December, a Texas federal district court judge ruled the law was unconstitutional without its individual mandate penalty, which was removed by Congress in 2017. An Urban Institute report published in March estimated as many as 20 million people would lose insurance if the lawsuit to terminate the ACA is successful, with the majority of uninsured having been covered through state Medicaid expansions and ACA exchanges.

Researchers at the Brookings Institution and the USC Schaeffer Center for Health Policy & Economics warned in June that attempts to undermine the ACA would result in a massive drop in enrollment rates. The Congressional Budget Office later estimated as many as 3 million would leave the exchanges and group markets for the same reasons. Enrollment only declined by 300,000 for this year.

CDC reports insured rates for those under the age of 65 enrolled in high-deductible commercial plans increased from 43.7% in 2017 to 45.8% in 2018. The percentage of uninsured adults aged 45-64 increased from 9.3% in 2017 to 10.3% in 2018.

The survey notes "significant decreases" in uninsured rates among Hispanic, non-Hispanic black, non-Hispanic white and non-Hispanic Asian adults between 2013 through 2018. Hispanic adults experienced the greatest drop in uninsured rates during that time period, from 40.6% in 2013 to 26.7% in 2018. CDC reported there were no significant changes between 2017 and 2018.